轻中度帕金森病患者狭窄通道行走的步态特征研究  

A study of the gait characteristics of patients with mild to moderate Parkinson’s disease during narrow path walking

作　　者：张巧荣 郄淑燕 方伯言[2] 王丛笑 王虎军 席家宁[3] ZHANG Qiaorong;QIE Shuyan;FANG Boyan(Beijing Rehabilitation Hospital Affiliated to Capital Medical University,Beijing,100144)

机构地区：[1]首都医科大学附属北京康复医院康复诊疗中心,北京市100144 [2]首都医科大学附属北京康复医院神经康复中心 [3]首都医科大学附属北京康复医院医院办公室

出　　处：《中国康复医学杂志》2022年第7期894-900,共7页Chinese Journal of Rehabilitation Medicine

基　　金：国家重点研发计划项目(2018YFC0115405);首都医科大学附属北京康复医院临床研究培育专项(2020bkky-053)。

摘　　要：目的:分析轻中度帕金森病患者狭窄通道行走时的三维步态参数特征。方法:选取36例H-Y分期1—3期的轻中度帕金森病患者,36例健康受试者作为对照,分别测量在正常通道和狭窄通道通行时的三维步态参数。对两种路径通行时患者和健康受试者的时空参数、运动学参数及力学参数进行分析。结果:轻中度帕金森病患者在正常通道和狭窄通道两种不同路径下通行时,运动学参数均没有显著差异(P>0.05),时空参数中步长、步速、摆动相、单支撑相无显著差异(P>0.05),而与正常通道相比,患者在通过狭窄通道时的步频变快(P<0.05),双支撑相延长(P<0.05),跨步时间变短(P<0.05)。力学参数表现为狭窄通道行走时的地面反作用力矢状轴第二峰值较正常行走增大(P<0.05),其它方向地面反作用力无显著差异。而健康人群各个参数均无显著差异(P>0.05)。结论:轻中度帕金森病患者在狭窄通道行走时步态时空学和动力学参数发生改变,步行稳定性及应对复杂环境的能力下降。Objective:To investigate the three-dimensional gait characteristics in narrow path in patients with Parkinson’s disease.Method:Thirty-six patients with mild and moderate Parkinson’s disease in H-Y 1—3 stage were selected,and36 healthy subjects were selected as controls.The three dimensional gait parameters were measured when they passed through the wide path and narrow path respectively.The spatiotemporal parameters,kinematic parameters and kinetic parameters of those patients were analyzed.Result:No difference of kinematics parameter was found between narrow and wide path for normal subjects and patients with mild and moderate Parkinson’s disease.Comparing those between wide path and narrow path,no significant difference was found in stride length(P>0.05),walking speed(P>0.05),swing phase(P>0.05)and single support(P>0.05)in patients with mild and moderate Parkinson’s disease.Compared with the wide path,the cadence was faster(P<0.05),the double support phase was longer(P<0.05),and the stride time was shorter(P<0.05)in narrow path.In kinetic parameters,the second peak value of ground reaction force in sagittal axis was greater(P<0.05)in narrow path than in normal path,but there was no significant difference in other directions in patients with mild and moderate Parkinson’s disease.The above parameters were no any difference between the two paths in healthy subjects(P>0.05).Conclusion:The spatiotemporal and dynamic parameters of gait in patients with mild-moderate Parkinson’s disease were changed when walking in narrow paths,and the walking stability and ability to cope with complex environment were decreased.

关 键 词：帕金森病 狭窄通道 三维步态分析 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]